Allergic BronchopulmonaryAspergillosis ABPA
Allergic BronchopulmonaryAspergillosis ABPA

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Allergic BronchopulmonaryAspergillosis
Hypersensitivity to aspergillus inpatients with long standing asthma

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AspergillosisClassification
Non-invasive aspergillosis
Fungus ball found in old TB cavity
Invasive pulmonary aspergillosis
Lymphoma/leukemia patients
Multiple nodules which may cavitate
Frequently fatal
Allergic bronchopulmonary aspergillosis

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Acute ABPA
Type I reaction
Immediate hypersensitivity (IgE-mediated)
Histologically
Alveoli filled with eosinophils

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Chronic ABPA
Type III reaction
Delayed immune complex response=Arthusreaction (IgG-mediated)
Histologically
Damage to bronchial wall

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ABPAX-ray Appearance
Patchy, fleeting infiltrates
Usually in upper lobes
Thickened bronchial walls
“Finger-in-glove” “toothpaste shadow”
Mucus plugs in bronchi remain for months andgrow in size
Central bronchiectasis
Ring shadows around hilum

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ABPAX-ray Appearance
Lobar consolidation (32%)
Atelectasis (14%)
Cavitation (14%)
Pulmonary fibrosis

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ABPADiagnostic Criteria
Asthma
Blood eosinophilia
Immediate skin rx to aspergillus
Elevated IgE
Central bronchiectasis

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